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Iontophoresis

Iontophoresis. By Ashley Tanner. How Does it Work?. Iontophoresis works by driving medication through the skin using a low-voltage direct currant. The medication will have a positive or negative charge, and is placed under the electrode with the same charge.

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Iontophoresis

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  1. Iontophoresis By Ashley Tanner

  2. How Does it Work? • Iontophoresis works by driving medication through the skin using a low-voltage direct currant. • The medication will have a positive or negative charge, and is placed under the electrode with the same charge. • The medication travels through sweat ducts, oil ducts, and hair follicles to get to the desired area

  3. What is it used for? • Iontophoresis is most commonly used to decrease inflammation, and localized pain. • Other uses: treat calcium deposits, scar tissue, scars, and edema.

  4. http://www.youtube.com/watch?v=ssDStpwy-f4 • 4:20

  5. Dexamethasoneiontophoresis and acute muscle soreness • Study done by Cheatham CC, Doyle AT, Miller MG, 2011 • The study examined the effects of dexamethasoneiontophoresis on DOMS (delayed onset of muscle soreness) of the biceps brachii.

  6. Procedure • 20 participants were given an eccentric exercise protocol for the biceps. • The study was double blind • Every patient was given treatments of iontophoresis at 24 and 48 hours after exercise. • The experimental group was given dexamethasone • The control group was given a saline solution

  7. How was it measured? • Each patient had blood drawn before exercise, and 24 hours, 48 hours, and 72 hours post exercise. • They used muscle damage blood markers and inflammatory blood markers to see the effectiveness of the dexamethasone • They also had the patient subjectively measure their pain level

  8. Results • After the iontophoresis treatments, no difference was observed in the blood markers of the experimental group compared to the control group • The group that received dexamethasone reported similar pain levels as the group that received the saline solution

  9. Problems with this study? • The biceps brachii is a large area to treat with iontophoresis. • DOMS doesn’t begin to set in until 48-72 hours post exercise. The treatment was over by the time DOMS started to come on. This study shows that it doesn’t help prevent it, but in order to say it doesn’t treat it they would have to continue the treatments into the time when DOMS has set in.

  10. Problems with the study? • Patient group was relatively small • The biceps may not be superficial enough on the patients being treated for iontophoresis to be effective. Skin fold measurements might be helpful in determining the effectiveness of the study.

  11. How deep does it really go? • A study done by Coglianase, et al. 2011 at Brigham Young University • The study evaluated the effectiveness of iontophoresis to drive 1% Lidocane into the skin.

  12. Details of the study • 13 patients received iontophoresis treatments with Lidocane on the gastrocnemius muscle • All participants had a skin fold of 5mm or less on the surface of their calf • A microdialysis probe was inserted at 5mm below the surface of the skin of both legs of 10 participants, and 3mm below the surface of the skin on 3 patients

  13. Details of the study • 2 mL of 1% Lidocane was placed on the treatment site directly over the microdialysis probe. • The settings were set to a current charge of 40 mA/min for 10.5 minutes for all participants

  14. What did they find? • The microdialysis probes showed no lidocane a the 5mm depth. • They did however show lidocane at the 3mm depth

  15. What does this mean? • Iontophoresis was able to push the lidocane 3mm beneath the surface of the skin. Suggesting that this method of treatment is best used on small superficial areas

  16. Other successful treatments • Plantar faciitis (Allison GT, Osborne HR, 2006) -Acetic acid and dexamethasone • Lateral epichondylalgia (Ferslew, et al, 2006) - Lidocane

  17. Benefits of Iontophoresis • Can be used on a wide patient population • Noninvasive • Painless • Non-traumatic • Avoids gastric transit delay

  18. References • Allison GT, Osborne HR. Treatment of plantar fasciitis by LowDye taping and iontophoresis: short term results of a double blinded, randomised, placebo controlled clinical trial of dexamethasone and acetic acid. Br J Sports Med. 2006;40:545–549. www.bjsportmed.com. Accessed February 2013. • BeneshE, Eaton L, Gurney B, Lucak J, Wascher D. The Effect of Skin Thickness and Time in the Absorption of Dexamethasone in Human Tendons Using Iontophoresis. Journal Of Orthopaedic & Sports Physical Therapy. 2008; 38:238-245 • Cheatham CC, Doyle AT, Miller MG. Effect of DexamethasoneIontophoresis: Acute Muscle Injury of the Biceps Brachii. Athletic Training & Sports Health Care. 2011:3(6):260-270 • Coglianese M, Draper DO, Shurtz J, Mark G. Microdialysis and delivery of iontophoresis driven lidocaine into the human gastrocnemius muscle. Journal of Athletic Training. 2011:46(3):270-276

  19. References • Ebaugh D, Gard K. The use of acetic acid iontophoresis in the management of a soft tissue injury. North America Journal of Sports Physical Therapy. 2010:5(4):220-226 • English SE, Daniels JC, Hasson SM, Reich M. Effect of Iontophoretically Delivered Dexamethasone on Muscle Performance in a Rheumatoid Arthritic Joint. Arthritis Care and Research. 1988:1(3)177-182 • Ferslew KE, Kalbfleish JH, Panus PC, Yarrobion TE. Lidocaineiontophoresis mediates analgesia in lateral epicondylalgia treatment. Physiotherapy Research International. 2006:11(3):152-160 • Freitag F, Pearlman SH, Rapoport AM. Innovative delivery systems for migraine. The clinical utility of a transdermal patch for the acute treatment of migraine. CNS Drugs. 2010:24(11):929-940

  20. Questions?

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